DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: COMMONWEALTH OF KENTUCKY

MEDICARE: COMMONWEALTH OF KENTUCKY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320600000XIntellectual and/or Developmental Disabilities Residential Treatment Facility100426KY
2333600000XPharmacyPO5076KY
33336L0003XLong Term Care PharmacyPO5076KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679571830
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMONWEALTH OF KENTUCKY
Provider Business Mailing Address
First Line : 2441 SOUTH HIGHWAY 27
Second Line :
City : SOMERSET
State : KY
Zip : 42501
Country : US
Telephone Number : 606-677-4068
Fax Number : 606-677-4079
Provider Business Practice Location Address
First Line : 2441 SOUTH HIGHWAY 27
Second Line :
City : SOMERSET
State : KY
Zip : 42501
Country : US
Telephone Number : 606-677-4068
Fax Number : 606-677-4079
Authorized Official
Title or Position : DIRECTOR
Name : STEPHANIE CRAYCRAFT
Credential :
Telephone Number : 502-782-6243
Provider Enumeration Date : 07/12/2005
Last Update Date : 02/19/2018

Similar Medicare Providers

1689396434 — NICHOLAS A RIVES LPCC
Practice Location Address:
600 MONTICELLO ST
SOMERSET, KY
42501-2974
Practice Phone: 606-383-1948
Practice Fax: 606-244-4111
1669311387 — LESLIE ANN CALDWELL LPCA
Practice Location Address:
200 BELMONT AVE
SOMERSET, KY
42501-2419
Practice Phone: 606-687-2038
Practice Fax: 600-200-3654
1215562012 — BRITNEY LUTTRELL LCSW
Practice Location Address:
200 BELMONT AVE
SOMERSET, KY
42501-2419
Practice Phone: 606-687-2038
Practice Fax: 606-200-3654
1013474956 — JANIE SHANAE DAY CSW
Practice Location Address:
200 BELMONT AVE
SOMERSET, KY
42501-2419
Practice Phone: 66-872-0386
Practice Fax: 606-200-3654
1285340257 — CODY GRIGGS LPCA
Practice Location Address:
200 BELMONT AVE
SOMERSET, KY
42501-2419
Practice Phone: 606-687-2038
Practice Fax: 606-200-3654
1669145983 — JENNIFER DAVIS
Practice Location Address:
200 BELMONT AVE
SOMERSET, KY
42501-2419
Practice Phone: 606-687-2038
Practice Fax: 606-200-3654
1851185938 — SHELBY ROBERTS CSW
Practice Location Address:
200 BELMONT AVE
SOMERSET, KY
42501-2419
Practice Phone: 606-687-2038
Practice Fax:

Directions to “COMMONWEALTH OF KENTUCKY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.